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ObjectiveTo investigate the trends and significant determinants of delayed HIV diagnosis (DHD) among newly reported HIV/AIDS cases in Xuhui District, Shanghai between 2018 and 2022. MethodsIn the newly reported HIV/AIDS cases, patients died within one year without accident, HIV/AIDS cases with CD4 cell count <200 cells·μL-1, and AIDS cases with a CD4 cell count between 200 to 499 cells·μL-1 were defined as delayed diagnosis. Univariate and multivariate logistic analysis were employed to explore the influencing factors of DHD. ResultsAmong the 862 newly reported HIV/AIDS cases, The DHD rate was 39.79% without statistically significant difference by year(χ2=4.508, P=0.342). Patients with CD4 cell count <200 cells·μL-1 contributed the largest proportion of DHD. During 2018‒2022, the DHD rate declined among HIV/AIDS patients who were younger than 35 years old or 45‒65 years old, never married, original diagnosis from tertiary specialized hospitals. Patients who were 65 years or older, married or divorced, with heterosexual transmitted HIV/AIDS, and original diagnosis from other types of testing and tertiary metropolitan hospital, had sustainably higher DHD rates. The number of HIV screening and diagnosed from voluntary counseling and testing (VCT) decreased during the COVID-19 epidemic, while the DHD rate increased sharply. Multivariate logistic regression analysis suggested the DHD rates were higher among older age, other types of testing(OR=3.805, 95%CI: 2.260‒6.406)and pre-operative testing(OR=2.411, 95%CI: 1.424‒4.081). Patients who received CD4 test in 15 days had a higher DHD rate compared to the cases received CD4 test exceeding 90 days (OR=0.336, 95%CI: 0.216‒0.522). ConclusionThere is no significant decrease of delayed HIV diagnosis rate in Xuhui District in recent years, and the number of HIV tests has decreased in 2022. Monitoring of newly reported HIV/AIDS should be conducted continuously. Expansion of HIV antibody screening should be conducted in non-infectious departments and inpatient departments in healthcare institutions, particularly metropolitan hospitals. Assistance should be provided to clinicians and elderly patients for improving their ability to recognize and perceive the risk of HIV/AIDS, in order to enhance early diagnosis and subsequent treatment.
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ObjectiveTo investigate the latent tuberculosis infection (LTBI) of close contacts in schools of Xuhui District, and to explore the tuberculin skin test (TST)- interferon-γ release assay (IGRA) two-step method in order to discover the screening strategy of tuberculosis in Xuhui District. MethodsClose contacts of tuberculosis in schools of Xuhui District from 2020 to 2022 were selected as research subjects. Screening was conducted using symptom questionnaire, TST, chest X-rays, IGRA, and the information including the etiological results and grade of the index cases, as well as gender, age, and relationship with the index cases of the research subjects were collected. ResultsTotally 615 close contacts of 32 tuberculosis cases occurred in the schools were finally included. Of the 609 close contacts who completed tuberculosis infection screening and underwent TST testing, 153 TST(+) individuals underwent IGRA testing. The final LTBI rate was 4.6%, and the pulmonary tuberculosis detection rate was 163 per 100 000. The relationship with the index cases was an influencing factor for LTBI. The IGRA positivity rate was higher among close contacts with TST ≥15 mm than among those with 10 mm≤ TST <15 mm (χ2=14.41, P<0.05). ConclusionThe latent tuberculosis infection among close contacts of school tuberculosis cases in Xuhui District remains serious. TST-IGRA two-step method can assist in the accurate diagnosis of LTBI and pulmonary tuberculosis cases.
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Purpose To investigate the relationship between ultrasonic manifestations in prostate cancer (PCa) and Gleason score,and improve the clinical value of transrectal ultrasound (TRUS) examination of PCa.Materials and Methods 362 patients with PCa treated in the First Affiliated Hospital of Soochow University from September 2009 to January 2015 were analyzed retrospectively,according to TRUS examination,the ultrasonic manifestations of PCa were divided into the localized type,diffuse type and negative type.Gleason score of pathological tissue divided the risk factor of PCa into low risk (<7 points),medium risk (=7 points),and high risk (>7 points).The relationship between ultrasonic manifestations of PCa and risk factor was analyzed.Results Ultrasonic results showed that,for the 362 patients with PCa,patients with ultrasonic negative manifestations accounted for 32.9% (119/362) and those with ultrasonic positive manifestations accounted for 67.1% (243/362),including 38.7% (140/362) localized type and 28.4% (103/362) diffuse type.In localized and diffuse PCa,the number of patients in high risk group was significantly more than the low risk group,and the difference among the high risk,medium risk and low risk groups was statistically significant (P<0.05);in the low risk group,the ultrasonic negative manifestations were more than the positive manifestations,and the difference was statistically significant (P<0.05);in high risk group,the localized and diffuse manifestations were more than the negative manifestations and the difference was statistically significant (P<0.05).Conclusion TRUS shows more clinical values in the diagnosis and treatment of PCa,and the ultrasonic positive manifestations can preliminarily evaluate the risk factor of PCa.
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Objective Human bone marrow mesenchymal stem cells were transfected by Smad7 and labeled with green fluores-cent mark.BMMSCs were implanted into rabbit glaucoma operational model and observed surviving condition.Methods Through BP and LR reaction,Smad7 with green fluorescent mark was inserted into human bone marrow mesenchymal stem cells by bacterio-phage,filtered positive colony and picked out cell line.15 New Zealand white rabbits were enforced trabeculectomy with BMMSC, then following up cell survival condition.Results Smad7 expressed stable in human bone marrow mesenchymal stem cells with sat-isfactory green fluorescent mark.BMMSC survived in rabbit trabecula with stable green fluorescent and effective ocular press.Con-clusion Smad7 with green fluorescent mark could be inserted into human bone marrow mesenchymal stem cells stably,and has ef-fective results in rabbit model.
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Objective To evaluate the diagnostic and differential diagnostic effects of ultrasound in testicular tumors and tumor-like lesions.Methods Ultrasound features of 33 cases of testicular masses were reviewed and the results were compared with pathological findings.Results For the 33 cases of testicular masses,12 cases were diagnosed as seminoma,6 cases as lymphoma,6 cases as epidermoid cyst,2 cases as mixed germ cell tumor,2 cases as teratoma,1 case as embryonal carcinoma,1 case as endodermal sinus tumor and 3 cases of the other tumor.Conclusions Ultrasound has important value in the diagnosis and differential diagnosis of testicular tumor and tumor-like lesions,and it can be considered first choice of clinical imaging examination.
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Objective To explore the incidence rate and related factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy(DRP). Methods The 986 patients(1 326 eyes) with DRP arranged vitro-retinal surgery were studied. The inci-dence rate of intraocular pressure was analyzed between different types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation and crystalline lens excision. Results The incidence rate of high intraocular pressure was 27. 8%(368/1 326). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher than non-pro-liferative DRP (17. 2%)(χ2 =30. 648,P=0. 000),and higher in DRP D grade than B grade(34. 1%,20. 8%)(χ2=8. 834,P=0. 003). The incidence rate of high intraocular pressure of proliferative DRP (34. 0%) was obviously higher in patients complicated with macular de-tachment(30. 4%,22. 7%)(χ2 =8. 834,P=0. 0030). The incidence rate of patients filled with silicone oil/C3F8(39. 1%,24. 0%) (χ2 =28. 088,P=0. 000),total/supplementary retina photo-coagulation(32. 8%,16. 8%) (χ2 =21. 159,P=0. 000),with/without crystal-line lens excision (40. 5%,25. 9%)(χ2=15. 532,P=0. 0001)was different obviously. Conclusion There is a high incidence rate and re-lated factors of high intraocular pressure after vitro-retinal surgery for patients with diabetic retinopathy,and it is related to different DRP types,grades,complicated with macular detachment,filled with silicone oil/C3F8,total/supplementary retina photo-coagulation,crystalline lens excision.
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Objective To assess the clinical significance of serum high sensitive C-reactive protein (hs-CRP) in patients undergone prostate biopsy.Methods A total of 273 consecutive patients were enrolled,aged 44-95 years (mean,69 years).All the patients underwent prostate biopsy.The pathological findings showed 96 cases with prostate cancer (PCa) and 177 cases with benign prostate hyperplasia (BPH).The difference of hs-CRP level between patients with PCa and those with BPH was analyzed.The positive prostate biopsy rate was compared between the patients with high hs-CRP level and those with normal hs-CRP level.Logistic regression was used to evaluate the effect of factors such as hs-CRP,tPSA,PSA density,prostate volume and age on prostate biopsy.Results The medians (interquartile range) of hs-CRP were 3.22 mg/L (1.22-9.84 mg/L) in patients with PCa and 1.24 mg/L (0.55-2.76 mg/L) in those with BPH,respectively,with significant difference(P<0.05).The positive prostate biopsy rate in patients with high hs-CRP (> 3 mg/L)was 55% (51/92),higher than that in those with normal hs-CRP (≤ 3 mg/L).The odds ratio of hs-CRP was larger than that of all other factors analyzed including tPSA,prostate volume and age according to the Logistic regression analysis.Conclusions Elevated serum hs-CRP level is associated with increased positive prostate biopsy.Serum hs-CRP acts as an independent factor increasing the positive prostate biopsy rate in patients undergone prostate biopsy.
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ObjectiveTo investigate the expression of paired immunoglobulin-like receptor B (PirB) in optic nerve, visual cortex, cerebella, spinal cord and sciatic nerve of normal adult mice.MethodsTwelve healthy adult BALB/c mice were randomly and equally divided into two groups.The immunohistochemistry and Western blot were used to detect the expression of PirB in the tissues described above respectively.ResultsBoth the immunohistochemistry and Western blot test revealed that the expression of PirB was positive in the optic nerve, visual cortex, cerebella and spinal cord, but negative in the sciatic nerve.The positive signals in the sections were located in the cell bodies and the neurites were observed in some of them.Western blot showed the apparent positive band of PirB in the optic nerve, visual cortex, cerebella and spinal cord rather than in the sciatic nerve.The protein expression level of PirB was relatively high in the visual cortex (P <0.05) but relatively low in the optic nerves (P <0.01).ConclusionThe PirB expresses positively in the optic nerve, indicating that PirB protein may closely correlate with the poor regeneration of the optic nerve.
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Objective To evaluate the value of transrectal contrast enhanced ultrasound(TR-CEUS) in diagnosis of benign and malignant prostatic neoplasms.Methods Sixty patients with elevated level of serum prostate specific antigen and suspected prostate diseases were examined with transrectal uhrasound(TRUS), and TR-CEUS.The pattern and intensity of CEUS in these patients were observed;and the patients with nodules were examined with CEUS guided biopsy and sextant system biopsy after ultrasound imaging.Time-intensity curves (TIC) were drawn to calculate the parameters, and the difference between benign and malignant nodes was compared.Results All sixty prostate patients were confirmed by pathological examination.Thirty-seven patients belong to benign lesions, among them 15 patients with nodule lesion had total 20 nodules, while 22 cases had benign prostatic hyperplasia.In 23 cases of malignant lesions, 18 cases had centralized nodules and 5 cases showed diffuse pathologic changes.Benign nodes of inner gland showed a main pattern of homogenous enhancement and a clear node zone, whereas, malignant nodes displayed significant enhancement in peripheral tissue.The time to peak and accelerating time (ACT) of malignant nodes were shorter than those of benign nodes (P <0.05).There was no significance in arrival time (AT) between the two groups (P>0.05).The accordance rate of TR-CEUS in the differential diagnosis of benign and malignant prostatic lesions was higher than that of TRUS (P<0.05).In addition, the sensitivity, specificity and accurate rate of TR-CEUS were higher than those of TRUS, whereas, both misdiagnosis and missed diagnosis rate of TR-CEUS were lower than those of TRUS.Conclusions TR-CEUS has clinical value for early discovery of prostatic cancer and has higher application value to differentiate malignant from benign diseases.
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Objective To evaluate diagnostic value of transrectal gray scale contrast enhanced ultrasound (CEUS) in distinguishing benign from malignant nodes of prostate. Methods Thirty-three patients with 38 prostate nodes underwent real-time transrectal gray scale CEUS with SonoVue and contrast pulsed sequence (CPS). Contrast enhancement pattern of the prostate nodes were recorded and time-intensity curves (TIC) were drawn to calculate the parameters and difference between benign and malignant nodes. Results Twenty benign nodes (17 in inner gland) and 18 malignant ones (14 in external gland) were confirmed by pathology. Compared with normal peripheral zone, malignant lesions showed significantly earlier time to enhancement. The time to peak (TTP), accelerating time (ACT) and peak intensity (PI) of malignant lesions were lower than those of benign lesions (P0.05). Conclusion Of all parameters in CEUS, TTP, ACT and PI are different between prostate benign and malignant lesions, and thus contribute to discriminate prostate cancer from benign diseases.
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Objective:To discuss the pathological relationship between P33ING1 and stomach cancer and its clinical significance. Methods: In 71 cases of stomach cancer specimen, twelve cases of gas tric mu cous membrane atypical hyperplasia tissues and 18 cases of normal gastric mucous membrane tissue(as control),the expression of P33ING1 were detected b y EnVision immunohistochemical method,while the expression of P53 and Bcl -2 in stomach cancer were also detected. Results: P33IN G1 expression in mucous membrane atypical hyperplasia group and control group was positive, the expression in stomach cancer group was extremely low(62.0%,44 /71), significantly different from the other 2 groups(P<0.01).P33ING1 expression in stomach cancer was related to the tumor growth, lymph node meta s tasis and tumor polarization (P<0.01), P53 expression was related to tumor s ize, growth and lymph node metastasis (P<0.01). Bcl-2 expression was relate d to lymph node metatasis and tumor polarization.The expression of P33ING1 was related to that of P53 in stomach cancer(P<0.05),while had no relation with that of Bcl-2.Conclusion:P33ING1 may play an importa nt role in the occurrance and development of stomach cancer.It's very important to detect the expression of P33ING1 and P53 simultaneously.